Journal of oncology practice
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The costs of cancer care are unsustainable in the present US health care system. Private payers have taken a leading role in oncology payment reform. This benefits all payers, including the Center for Medicare and Medicaid Services (CMS). ⋯ A common health information exchange pipeline will allow patients, physicians, and other health care providers to share structured information from multiple electronic medical record/electronic health record platforms. By allowing multiple payers, including CMS, to access commonly accepted clinical decision support rules, any payer can create contracts and relationships with oncology practices. In this manner, future changes in payment for oncology services mandated by CMS can be sustained within the infrastructures being built today through payer-provider collaborations.
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The American Society of Clinical Oncology (ASCO) published a study in 2007 that anticipated a shortage of oncologists by 2020. This study aims to update and better assess the market for chemotherapy and radiation therapy and the impact of health reform on capacity of and demand for oncologists and radiation oncologists. ⋯ Anticipated shortages are largely consistent with the projections of the ASCO 2007 workforce study but somewhat more delayed. The ACA may modestly exacerbate the shortage. Unless oncologist productivity can be enhanced, the anticipated shortage will strain the ability to provide quality cancer care.
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To measure the number and type of errors associated with chemotherapy order composition associated with three sequential methods of ordering: handwritten orders, preprinted orders, and computerized physician order entry (CPOE) embedded in the electronic health record. ⋯ The number of problem- and error-containing chemotherapy orders was reduced sequentially by preprinted order sets and then by CPOE. CPOE is associated with low error rates, but it did not eliminate all errors, and the technology can introduce novel types of errors not seen with traditional handwritten or preprinted orders. Vigilance even with CPOE is still required to avoid patient harm.